14D1023970 CLIA NUMBER - PROJECT VIDA INC

Laboratory Demographics

  • CLIA Code: 14D1023970
  • Facility Name: PROJECT VIDA INC
  • Facility Address: 2659 S KEDVALE AVE
    CHICAGO, IL
    ZIP 60623
  • Facility Phone: 773 522-4570
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: MICHAEL HENDERSON
  • NPI Number: 1285167577
  • Taxonomy: 1041C0700X - Social Worker

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CLIA Record

Field Name Field Value
CLIA Number 14D1023970
LAB Type Other
Facility Name PROJECT VIDA INC
Street 2659 S KEDVALE AVE
City CHICAGO
State IL
ZIP 60623
Phone 773 522-4570
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/30/2024
Certificate Expiration Date 3/29/2026
Facility Type Other
Lab Director MICHAEL HENDERSON

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This page was last updated on: 9/29/2025